Irish Medical Journal Press Release

Irish Medical Journal SEPTEMBER 2011 ■ Volume 104 ■ Number 8

Chronic obstructive pulmonary (COPD) is one of the leading causes of mortality and morbidity worldwide, according to a report in the most recent edition of the Irish Medical Journal. Although more prevalent in men, it is anticipated that, due to the convergence in smoking rates, the prevalence rate in women will surpass that of men.

O’Farrell et al reported, “There were 14,519 deaths attributable to COPD in the period 2000-2009. Although deaths decreased for both sexes, reduction in deaths was significantly higher among men. Smoking rates decreased for both sexes from 1980-2009 with the percentage reduction in smoking significantly greater in men.”

This study has also shown that there has been a convergence in the in-patient hospital discharge rate for COPD in men and women in Ireland. Given that patients admitted to hospital with COPD are likely to be suffering from severe exacerbations of the disease, the finding that female patients admitted with COPD were on average younger than male patients adds more evidence to the premise that women are more likely than men to develop early-onset COPD.

This is the first study in the Republic of Ireland to examine the effect of the convergence of historical smoking rates on COPD mortality and COPD hospital in-patient discharges.

This study provides evidence of the need for effective smoking cessation programmes that are targeted at women as well as men.

COPD is a general term for a number of chronic lung disorders also referred to as chronic bronchitis, emphysema, chronic obstructive airway disease and chronic airway flow limitation. It is a serious yet largely preventable and treatable chronic disease.

“The prevalence of COPD in Ireland is unknown but based on international figures it is estimated that at least 400,000 people in Ireland have COPD of whom over 180,000 have moderate or severe disease. The burden of COPD on health services is expected to increase in the future.”

The main risk factor for COPD is smoking; it is estimated that between 50-85% of cases of COPD can be attributable to either current or previous smoking. Although the disease is more prevalent in men, it is hypothesized that, due to the convergence in male and female smoking rates, the rates of COPD among women will surpass those of men in around 10 years.

This is because womens’ rates of tobacco use have typically lagged behind and peaked later than mens’ rate of smoking. Furthermore, studies have shown that women are more susceptible to COPD in response to smoking when exposed to the same amount of exposure to tobacco as men, and women are more likely to develop more severe and earlier on-set COPD than men.

The study highlights the substantial burden of COPD on acute hospital services in Ireland with lengthy hospital stays and repeat admissions being common. Given that our population is ageing and there is a greater number of older women than men in Ireland, we need to prepare for the growing burden of this disease on our health services by ensuring that adequate resources and best evidence based practice is used to care for these patients.

Educating patients, physicians, and the public to recognize that COPD is a preventable disease that may in the future be as common among women is of great importance. Continued monitoring of trends in COPD mortality and morbidity must be carried out.

All references are contained in the full print article on the IMJ website.